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Article ; Online: Hypnotic prescription trends and patterns for the treatment of insomnia in Japan: analysis of a nationwide Japanese claims database.

Okuda, Shoki / Qureshi, Zaina P / Yanagida, Yukiko / Ito, Chie / Homma, Yuji / Tokita, Shigeru

2023 Volume 23, Issue 1, Page(s) 278

Abstract: Background: There is limited consensus regarding the optimal treatment of insomnia. The recent introduction of orexin receptor antagonists (ORA) has increased the available treatment options. However, the prescribing patterns of hypnotics in Japan have ... ...

Abstract	Background: There is limited consensus regarding the optimal treatment of insomnia. The recent introduction of orexin receptor antagonists (ORA) has increased the available treatment options. However, the prescribing patterns of hypnotics in Japan have not been comprehensively assessed. We performed analyses of a claims database to investigate the real-world use of hypnotics for treating insomnia in Japan. Methods: Data were retrieved for outpatients (aged ≥ 20 to < 75 years old) prescribed ≥ 1 hypnotic for a diagnosis of insomnia between April 1 Results: We analyzed data for 130,177 new and 91,215 long-term users (2010-2019). Most new users were prescribed one MOA per year (97.1%-97.9%). In 2010, GABA Conclusion: Prescriptions for hypnotics among new and long-term users in Japan showed distinct patterns and trends. Further understanding of the treatment options for insomnia with accumulating evidence for the risk-benefit balance might be beneficial for physicians prescribing hypnotics in real-world settings.
MeSH term(s)	Aged ; Humans ; Male ; Benzodiazepines/therapeutic use ; Drug Prescriptions/statistics & numerical data ; East Asian People ; Hypnotics and Sedatives/therapeutic use ; Japan/epidemiology ; Sleep Initiation and Maintenance Disorders/drug therapy ; Sleep Initiation and Maintenance Disorders/epidemiology ; Insurance Claim Review/statistics & numerical data ; Databases, Factual/statistics & numerical data ; Female ; Young Adult ; Adult ; Middle Aged ; Receptors, Melatonin/agonists ; GABA-A Receptor Agonists/therapeutic use ; Orexin Receptor Antagonists/therapeutic use ; Sleep Aids, Pharmaceutical/therapeutic use
Chemical Substances	Benzodiazepines (12794-10-4) ; Hypnotics and Sedatives ; Receptors, Melatonin ; GABA-A Receptor Agonists ; Orexin Receptor Antagonists ; Sleep Aids, Pharmaceutical
Language	English
Publishing date	2023-04-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-023-04683-2
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Article: Factors Associated with Prescriptions for an Orexin Receptor Antagonist Among Japanese Patients with Insomnia: Analysis of a Nationwide Japanese Claims Database.

Okuda, Shoki / Qureshi, Zaina P / Yanagida, Yukiko / Ito, Chie / Homma, Yuji / Tokita, Shigeru

Drugs - real world outcomes

2023 Volume 10, Issue 2, Page(s) 271–281

Abstract: Background: Few studies have examined the prescribing patterns of orexin receptor antagonists (ORAs) in the real-world clinical setting in Japan.: Objective: We sought to analyze the factors associated with ORA prescriptions for patients with ... ...

Abstract	Background: Few studies have examined the prescribing patterns of orexin receptor antagonists (ORAs) in the real-world clinical setting in Japan. Objective: We sought to analyze the factors associated with ORA prescriptions for patients with insomnia in Japan. Methods: Outpatients (aged ≥ 20 to < 75 years old) prescribed one or more hypnotic for insomnia between April 1, 2018 and March 31, 2020 with continuous enrollment for ≥ 12 months were extracted from the JMDC Claims Database. We performed multivariable logistic regression to identify factors (patient demographics and psychiatric comorbidities) associated with ORA prescription in new or non-new users of hypnotics (patients without or with hypnotics prescription history, respectively). Results: Of 58,907 new users, 11,589 (19.7%) were prescribed ORA at the index date. Male sex (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.12-1.22) and presence of bipolar disorders (OR 1.36, 95% CI 1.20-1.55) were associated with greater odds of ORA prescription. Among 88,611 non-new users, 15,504 (17.5%) were prescribed ORA at the index date. Younger age and several psychiatric comorbidities, such as neurocognitive disorders (OR 1.64, 95% CI 1.15-2.35), substance use disorders (OR 1.19, 95% CI 1.05-1.35), bipolar disorders (OR 1.14, 95% CI 1.07-1.22), schizophrenia spectrum disorders (OR 1.07, 95% CI 1.01-1.14), and anxiety disorders (OR 1.05, 95% CI 1.00-1.10), were associated with greater odds of ORA prescription. Conclusion: This is the first study to determine the factors associated with ORA prescriptions in Japan. Our findings could help guide appropriate insomnia treatment using ORAs.
Language	English
Publishing date	2023-03-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2806600-5
ISSN	2198-9788 ; 2199-1154
ISSN (online)	2198-9788
ISSN	2199-1154
DOI	10.1007/s40801-023-00356-4
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Article ; Online: Impact of refractory and unexplained chronic cough on disease burden: a qualitative study.

Ueda, Naoya / Yakushiji, Anzu / Schelfhout, Jonathan / Tokita, Shigeru / Kubo, Takekazu

BMC pulmonary medicine

2022 Volume 22, Issue 1, Page(s) 372

Abstract: Background: Chronic cough lasting for > 8 weeks is a common medical condition that burdens patients. This study aimed to qualitatively describe knowledge, awareness, experiences, and subtypes of burdens (physical, social, psychological) among Japanese ... ...

Abstract	Background: Chronic cough lasting for > 8 weeks is a common medical condition that burdens patients. This study aimed to qualitatively describe knowledge, awareness, experiences, and subtypes of burdens (physical, social, psychological) among Japanese patients with refractory chronic cough (refractory to treatment of underlying relevant medical conditions) and unexplained chronic cough (symptoms of unexplained origin). Methods: This non-interventional, cross-sectional study was conducted between February and March 2021 among patients (aged ≥ 20 years) with self-reported refractory or unexplained chronic cough. Subjects with a history of comorbid respiratory conditions were excluded. Eligible subjects participated in a 60-min online semi-structured interview. Verbatim terms from interviews were qualitatively transcribed and generated into word clouds, followed by a clustering analysis in which meaningful clusters were chosen, manually coded, and utterances and burdens categorized. Results: A total of 21 participants (95.2% with refractory chronic cough, mean age 53.5 years, and 76.2% being males) with Leicester Cough Questionnaire mean ± standard deviation scores of physical 4.8 ± 1.1, psychological 4.4 ± 1.3, social 4.9 ± 1.4, and total 14.1 ± 3.5 were included. The word cloud identified the most frequently used word ('cough'); etiology ('asthma'); and words associated with change in states ('influence,' 'changing,' 'change') and expressions ('tough,' 'pain,' 'hard,' 'terrible,' 'unpleasant'). The patients experienced 'mental/social burden,' 'physical burden,' 'impact on sleep and meals,' 'impact on work and housework,' 'impact on communication,' 'impact on hobbies and leisure,' and 'economic burden.' By closed coding analysis, the situations or types of burden patients experienced from the cough were ordered sequentially as emotion, working style, acquaintanceship, hobbies and leisure, and sleeping pattern. Conclusions: The present study indicated that there were two types of participant clusters, in which one showed mainly the burdens in the social communications such as work-related communication and another one showed the burdens of relationships with others. Also, some participants highlighted 'mental burden,' on social life due to the current pandemic. To relieve these burdens, disease awareness and knowledge should be improved for patients with refractory and unexplained chronic cough. Trial registration The trial was registered under UMIN-CTR as UMIN000042772, on 17/12/2020. The study was approved by the Medical Corporation Toukeikai Kitamachi Clinic (IRB registration number: 11001110).
MeSH term(s)	Chronic Disease ; Cost of Illness ; Cough/psychology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Qualitative Research
Language	English
Publishing date	2022-10-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-022-02171-z
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Article ; Online: Clinical characteristics and drug utilisation patterns in patients with chronic cough: a retrospective cohort study using a Japanese claims database.

Arai, Yoko / Okuyama, Kotoba / Onishi, Yoshie / Schelfhout, Jonathan / Tokita, Shigeru / Kubo, Takekazu

BMC pulmonary medicine

2022 Volume 22, Issue 1, Page(s) 429

Abstract: Background: Although unmet medical needs for better care of patients with chronic cough exist in Japan, epidemiological information about these patients and their treatments is very limited.: Objectives: To describe patient characteristics, ... ...

Abstract	Background: Although unmet medical needs for better care of patients with chronic cough exist in Japan, epidemiological information about these patients and their treatments is very limited. Objectives: To describe patient characteristics, underlying cough-related diseases and drug utilisation patterns in patients with chronic cough, and their changes over time. Methods: This large retrospective claims database study enrolled subjects with chronic cough, identified either by a specific diagnostic cough code for chronic cough (Population 1) or by multiple cough-related diagnostic codes spanning > 8 weeks (Population 2). Within Population 2, patients with each of the three most frequent diagnostic cough codes were analysed as subgroups. Patient characteristics, underlying cough-related diseases and utilisation patterns for drugs used for cough were documented at the index date, during the 6-month pre-index period and during the 12-month post-index period. Results: 6,038 subjects were enrolled in the cohort (Population 1: N = 3,500; Population 2: N = 2,538). The mean age was 43.7 ± 12.2 years and 61.8% were women. The largest cough diagnosis subgroups in Population 2 were 'other coughs' (N = 1,444), 'cough-variant asthma' (N = 1,026) and 'atopic/allergic cough' (N = 105). At the index date, the most frequent underlying cough-related diseases were allergic rhinitis/nasal inflammation (N = 3,132; 51.9%), asthma (N = 2,517; 41.7%) and gastro-esophageal reflux disease (N = 829; 13.7%). At the index date, 4,860 participants (80.5%) were prescribed at least one cough-related treatment. 194 participants (4.0% of medication users) were prescribed central antitussives alone, principally in Population 1, and 2,331 (48.0%) were prescribed expectorants. Other frequently prescribed medications were antiallergic drugs (N = 2,588; 53.3%), antimicrobials (N = 1,627; 34.4%) and inhaled corticosteroids with long-acting beta-agonists (N = 1,404; 28.9%). Over time, cough diagnoses tended to be lost, with only 470 participants in Population 1 retaining a diagnostic code for chronic cough one year later. The frequency of underlying cough-related diseases was stable over time. Conclusions: Patients in this cohort with chronic cough are most frequently identified by a diagnostic cough code for chronic cough, followed by codes for other coughs, cough-variant asthma and atopic cough. Chronic cough frequently presents with an underlying cough-related disease, most frequently allergic rhinitis/nasal inflammation, asthma or GERD. Medication prescription for the underlying cough-related diseases was generally appropriate.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Male ; Cough/drug therapy ; Cough/epidemiology ; Japan/epidemiology ; Retrospective Studies ; Drug Utilization ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/epidemiology ; Asthma/complications ; Asthma/drug therapy ; Asthma/epidemiology ; Rhinitis, Allergic ; Hypersensitivity, Immediate ; Inflammation
Language	English
Publishing date	2022-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-022-02180-y
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Article ; Online: Comorbidities and complications in Japanese patients with type 2 diabetes mellitus: Retrospective analyses of J-DREAMS, an advanced electronic medical records database.

Ohsugi, Mitsuru / Eiki, Jun-Ichi / Iglay, Kristy / Tetsuka, Jumpei / Tokita, Shigeru / Ueki, Kohjiro

Diabetes research and clinical practice

2021 Volume 178, Page(s) 108845

Abstract: Aims: To investigate the prevalence of comorbid conditions/complications among Japanese patients with type 2 diabetes mellitus (T2DM) in a real-world setting.: Methods: We performed retrospective analyses of a large-scale database directly linked to ... ...

Abstract	Aims: To investigate the prevalence of comorbid conditions/complications among Japanese patients with type 2 diabetes mellitus (T2DM) in a real-world setting. Methods: We performed retrospective analyses of a large-scale database directly linked to electronic medical records, J-DREAMS (Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System), to determine the prevalence of clinically significant comorbid conditions/complications among Japanese patients with T2DM aged ≥ 20 years with ≥ 1 clinical encounter at a referral center between April 1, 2017 and March 31, 2019. Results: Data were available for 10,151 patients (39.2% female). The mean age and T2DM duration were 66.0 years and 16.1 years, respectively. Only 0.5% had isolated T2DM, 6.6% had one comorbid condition/complication, and the remainder had multiple comorbid conditions/complications. Dyslipidemia (84.7%) and hypertension (75.1%) were the most common, followed by chronic kidney disease (35.4%), retinopathy (23.1%), and cardiovascular diseases (22.1%). Overall, 36.0% of patients were overweight/obese (body mass index ≥ 25 kg/m Conclusions: We revealed a high prevalence of comorbid conditions/complications, including chronic kidney and cardiovascular diseases, in Japanese patients with T2DM.
MeSH term(s)	Child, Preschool ; Comorbidity ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Electronic Health Records ; Female ; Humans ; Japan/epidemiology ; Male ; Prevalence ; Retrospective Studies
Language	English
Publishing date	2021-04-30
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2021.108845
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Article: [Emerging progress and strategies for the exploration of therapeutic targets].

Tokita, Shigeru

Nihon yakurigaku zasshi. Folia pharmacologica Japonica

2007 Volume 129, Issue 2, Page(s) 119–123

MeSH term(s)	Drug Design ; Genome, Human ; Genomics ; Humans ; Ligands ; Orexin Receptors ; Receptors, G-Protein-Coupled ; Receptors, Histamine H3 ; Receptors, Neuropeptide
Chemical Substances	Ligands ; Orexin Receptors ; Receptors, G-Protein-Coupled ; Receptors, Histamine H3 ; Receptors, Neuropeptide
Language	Japanese
Publishing date	2007-01-01
Publishing country	Japan
Document type	Journal Article ; Review
ZDB-ID	1097532-9
ISSN	1347-8397 ; 0015-5691
ISSN (online)	1347-8397
ISSN	0015-5691
DOI	10.1254/fpj.129.119
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Zs.A 439: Show issues

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Article ; Online: Treatment patterns and satisfaction in patients with type 2 diabetes newly initiating oral monotherapy with antidiabetic drugs in Japan: results from the prospective Real-world Observational Study on Patient Outcomes in Diabetes (RESPOND).

Tajima, Atsushi / Tobe, Keisuke / Eiki, Jun-Ichi / Origasa, Hideki / Watada, Hirotaka / Shimomura, Iichiro / Tokita, Shigeru / Kadowaki, Takashi

BMJ open diabetes research & care

2022 Volume 10, Issue 6

Abstract: Introduction: To present longitudinal data from the Real-world Observational Study on Patient Outcomes in Diabetes (RESPOND) in Japan.: Research design and methods: In this multicenter, prospective, observational cohort study, patients with type 2 ... ...

Abstract	Introduction: To present longitudinal data from the Real-world Observational Study on Patient Outcomes in Diabetes (RESPOND) in Japan. Research design and methods: In this multicenter, prospective, observational cohort study, patients with type 2 diabetes mellitus (T2DM) newly initiated on monotherapy were followed up for 2 years. Primary outcomes included changes in treatment pattern over time, target hemoglobin A1c (HbA1c) attainment and treatment satisfaction per Oral Hypoglycaemic Agent Questionnaire (OHA-Q). Results: Among 1474 enrolled patients (male, 62.1%; mean age, 59.7 years; HbA1c, 8.08%), the oral antidiabetic drug (OAD) monotherapy prescription rate decreased to 47.2% and that of 2 and ≥3 OADs increased to 14.8% and 5.4% at 24 months, respectively. Switch/add-on OAD was associated with higher HbA1c and body mass index (BMI), baseline OAD being non-dipeptidyl peptidase-4 inhibitor (DPP-4i)/non-sodium glucose cotransporter-2 inhibitor (SGLT2i), diabetes complications, no comorbidities and consulting a diabetes specialist. The mean (SD) HbA1c (%) was 6.73 (0.85) at 24 months. Higher HbA1c, diabetes complications, cardiovascular disease, being employed, no hypertension and younger treating physician were associated with ≥2 OAD classes prescription or target HbA1c non-attainment at 24 months. OHA-Q subscale scores were significantly higher in patients achieving (vs not achieving) target HbA1c and in those continuing monotherapy (vs combination therapy). Baseline age (<65 years), sex (female), HbA1c, alcohol use, use of non-‍DPP-4i OADs or non-T2DM drugs, diabetes complications and cardiovascular disease had a significant negative impact, while EuroQol five-dimensional five-level and Summary of Diabetes Self-Care Activities-specific diet scores, BMI and unemployment had a significant positive impact on OHA-Q scores at 24 months. Conclusions: Primary outcomes show real-world treatment patterns and glycemic control over 2 years in patients with T2DM newly initiated on OAD monotherapy in Japan. Key factors associated with durability of initial monotherapy, target achievement or treatment satisfaction included baseline HbA1c, comorbidity and initial OAD choice.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Middle Aged ; Blood Glucose ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Dipeptidyl-Peptidase IV Inhibitors/therapeutic use ; Drug Therapy, Combination ; Glycated Hemoglobin ; Hypoglycemic Agents/therapeutic use ; Japan/epidemiology ; Patient Satisfaction ; Prospective Studies
Chemical Substances	Blood Glucose ; Dipeptidyl-Peptidase IV Inhibitors ; Glycated Hemoglobin ; Hypoglycemic Agents
Language	English
Publishing date	2022-12-13
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2732918-5
ISSN	2052-4897 ; 2052-4897
ISSN (online)	2052-4897
ISSN	2052-4897
DOI	10.1136/bmjdrc-2022-003032
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Article ; Online: [Adherence to Oral Antihyperglycemic Agents (Dipeptidyl Peptidase-4 Inhibitors and Biguanides) and Its Associated Factors in Patients with Type 2 Diabetes].

Hayashi, Ai / Kubo, Takekazu / Okuyama, Kotoba / Tokita, Shigeru / Kamei, Miwako

Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan

2019 Volume 139, Issue 12, Page(s) 1569–1581

Abstract: To investigate medication adherence to oral antihyperglycemic agents and its associated factors in Japanese type 2 diabetic patients, a questionnaire survey was conducted in 983 adult patients receiving once-daily (QD) or twice-daily (BID) dipeptidyl ... ...

Abstract	To investigate medication adherence to oral antihyperglycemic agents and its associated factors in Japanese type 2 diabetic patients, a questionnaire survey was conducted in 983 adult patients receiving once-daily (QD) or twice-daily (BID) dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitor) or BID biguanides (BG) as monotherapy at 502 pharmacies in Japan. The percentage of patients with good adherence (the proportion of days in which patients took all pills as prescribed in the past 7 days ≥80%) was high (≥90%) in any dosing regimen with no significant difference among the groups. The following factors were identified as associating with good adherence: the longer duration of type 2 diabetes (≥1 year) (p=0.002), "Feeling your disease gets worse if you don't take medications" (p=0.031), "Not forgetting to bring along your medicine when you leave home" (p=0.007), "Feeling anxiety on taking medications for long period of time" (p=0.042), "Neither feeling nor not feeling anxiety on taking medications for a long period of time" (p=0.004), "Never run out of your medicine because you get a refill on time" (p=0.035), and the lower MMAS-4 score (p<0.001). Subgroup analyses revealed that adherence of younger patients (<65 years) with BG (BID) was lower than those with DPP-4 inhibitor (QD) (p=0.021). Additionally, around 60% of patients currently prescribed with QD preferred QD regimen, and ≥80% patients prescribed with BID equally preferred once-weekly or QD regimen, suggesting a large discrepancy exists between their preference and the actual regimen in patients on BID.
MeSH term(s)	Administration, Oral ; Adult ; Aged ; Anxiety ; Biguanides/administration & dosage ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/psychology ; Dipeptidyl-Peptidase IV Inhibitors/administration & dosage ; Female ; Humans ; Hypoglycemic Agents/administration & dosage ; Male ; Medication Adherence/statistics & numerical data ; Middle Aged ; Young Adult
Chemical Substances	Biguanides ; Dipeptidyl-Peptidase IV Inhibitors ; Hypoglycemic Agents
Language	Japanese
Publishing date	2019-11-13
Publishing country	Japan
Document type	Journal Article
ZDB-ID	200514-1
ISSN	1347-5231 ; 0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
ISSN (online)	1347-5231
ISSN	0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
DOI	10.1248/yakushi.18-00197
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Zs.A 643: Show issues

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Article ; Online: Incidence rate and patient characteristics of severe hypoglycemia in treated type 2 diabetes mellitus patients in Japan: Retrospective Diagnosis Procedure Combination database analysis.

Ikeda, Yuika / Kubo, Takekazu / Oda, Eisei / Abe, Machiko / Tokita, Shigeru

Journal of diabetes investigation

2018 Volume 9, Issue 4, Page(s) 925–936

Abstract: Aims/introduction: To evaluate the incidence rate of and identify factors associated with severe hypoglycemic episodes in patients with treated type 2 diabetes mellitus.: Materials and methods: Using Diagnosis Procedure Combination hospital-based ... ...

Abstract	Aims/introduction: To evaluate the incidence rate of and identify factors associated with severe hypoglycemic episodes in patients with treated type 2 diabetes mellitus. Materials and methods: Using Diagnosis Procedure Combination hospital-based medical database, we carried out a retrospective cohort study to assess the incidence rate of severe hypoglycemia in treated type 2 diabetes mellitus patients. We evaluated the associations between severe hypoglycemia and age, sex, complications, and current use of insulin or sulfonylurea (SU) in a nested case-control study. Results: Of 166,806 eligible patients, 1,242 had episodes of severe hypoglycemia during the observational period. The incidence rate of the first hypoglycemic events was 3.70/1,000 patient years. Based on the nested case-control analysis, age was associated with hypoglycemic events with adjusted odds ratios (ORs) of 1.64 or 65-74-year-old patients and 3.79 for ≥75-year-old patients in comparison with 20-64-year-old patients. Comorbidities, such as cognitive impairment, cancer, macrovascular disease and diabetic complications (retinopathy, nephropathy and neuropathy), were associated with severe hypoglycemia, with adjusted ORs ranging from 1.25 to 3.80. Severe hypoglycemic events also increased in patients with current use of both SU and insulin, either SU or insulin, with adjusted ORs of 18.36, 6.31 or 14.07, respectively, compared with patients with other antihyperglycemic agents. In patients with an SU glimepiride, adjusted ORs increased dose-dependently from 3.65 (≤1 mg) to 13.34 (>2 mg). Conclusions: The incidence rate of severe hypoglycemia in this cohort was 3.70/1,000 patient years. Age, cognitive impairment, cancer, diabetic complications, current use of insulin + SU and SU dosage were identified as risk factors for severe hypoglycemia.
MeSH term(s)	Adult ; Aged ; Databases, Factual ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Hypoglycemic Agents/therapeutic use ; Incidence ; Insulin/therapeutic use ; Japan ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sulfonylurea Compounds/therapeutic use ; Young Adult
Chemical Substances	Hypoglycemic Agents ; Insulin ; Sulfonylurea Compounds
Language	English
Publishing date	2018-01-16
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2625840-7
ISSN	2040-1124 ; 2040-1116
ISSN (online)	2040-1124
ISSN	2040-1116
DOI	10.1111/jdi.12778
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Zs.A 6920: Show issues

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Article ; Online: Retrospective analysis of medical costs and resource utilization for severe hypoglycemic events in patients with type 2 diabetes in Japan.

Ikeda, Yuika / Kubo, Takekazu / Oda, Eisei / Abe, Machiko / Tokita, Shigeru

Journal of diabetes investigation

2018 Volume 10, Issue 3, Page(s) 857–865

Abstract: Aims/introduction: The present study aimed to describe hospital utilization and examine actual medical costs for severe hypoglycemic events in patients with type 2 diabetes mellitus in Japan.: Materials and methods: Medical resource utilization ... ...

Abstract	Aims/introduction: The present study aimed to describe hospital utilization and examine actual medical costs for severe hypoglycemic events in patients with type 2 diabetes mellitus in Japan. Materials and methods: Medical resource utilization associated with severe hypoglycemia was evaluated using a receipt database of acute-care hospitals in Japan. Patients with type 2 diabetes treated with antihyperglycemic agents were included. Severe hypoglycemic events were identified and divided into two groups: with or without hospitalization. Total and attributable medical costs per event were calculated based on the actual medical treatment after severe hypoglycemic events. Attributable costs were estimated from the receipt codes directly associated with the treatment of severe hypoglycemia. Results: In the hospitalized patients, the median length of hospital stay was 11 days, and the median total and attributable medical costs were ¥402,081 and ¥302,341, respectively. The majority of the hospitalized patients underwent a radiographic examination and general blood tests. Apart from the hospitalization costs, the costs associated with diagnosis accounted for 29.6% of the total medical costs. In the outpatients, 60.6% visited hospitals only once for the severe hypoglycemic event, whereas 11.4% visited hospitals daily for a week after the severe hypoglycemic event. The mean number of hospital visits of the outpatient after a severe hypoglycemic event was 2.7 ± 2.6 days. The median total and attributable medical costs were ¥265,432 and ¥4,628, respectively. Conclusions: Significant medical resources are used for the treatment of severe hypoglycemic events of patients with type 2 diabetes in Japan.
MeSH term(s)	Aged ; Biomarkers/analysis ; Blood Glucose/analysis ; Cost-Benefit Analysis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/economics ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Glycated Hemoglobin/analysis ; Health Care Costs ; Health Resources/economics ; Hospitalization/economics ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/diagnosis ; Hypoglycemia/economics ; Hypoglycemia/therapy ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/economics ; Insulin/adverse effects ; Insulin/economics ; Japan ; Male ; Prognosis ; Retrospective Studies
Chemical Substances	Biomarkers ; Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Insulin ; hemoglobin A1c protein, human
Language	English
Publishing date	2018-11-17
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2625840-7
ISSN	2040-1124 ; 2040-1116
ISSN (online)	2040-1124
ISSN	2040-1116
DOI	10.1111/jdi.12959
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In stock of ZB MED Cologne/Königswinter

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